Health

Intestinal parasites in Central American immigrants in the United States

Article Abstract:

The influx of Central Americans into the United States has increased within the past decade, placing new demands on the health care system in the United States. However, there is limited knowledge about the health care needs of Central American refugees. One study reported a high prevalence of intestinal parasites among Central American immigrant children residing in San Francisco, California. The prevalence of intestinal parasites, assessed by ova and parasite examinations of the stool, was evaluated in 216 Central Americans seen at a Los Angeles, California clinic during an eight-month period. Parasites were discovered in 53 percent (66) of the immigrants, and 85 percent of these parasites were pathogenic (disease-producing). Parasites were prevalent in 14 percent of 91 Central American children born in the United States, and pathogens were identified in 12 percent of these cases. The most common disease-causing microorganisms were Trichuris trichiura, Giardia lamblia, and Ascaris lumbricoides. Giardia lamblia was more prevalent among children less than five years old, whereas infections with helminths occurred more often among children aged six to 10 years. Helminths were not detected in immigrants residing in the United States for more than three years. The prevalence of intestinal parasites was not related to development of gastrointestinal symptoms. These findings support previous recommendations for screening, which should be based on extent of disease, effectiveness and safety of treatment, and costs. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health care in the United States: our dynamic jigsaw puzzle

Article Abstract:

In 1983, a presidential health commission declared that society should provide all persons with adequate health care, although the monetary and administrative contributions of the public and private sectors were not clarified. The roles of the federal government, private marketplace, and individual states in providing health care to the indigent remain controversial. Social insurance originated in Germany in 1883, and was first introduced into the United States as "Nine Standards for Compulsory Health Insurance" in 1912. Since then, many acts have been introduced to contribute to formation of a national health insurance (NHI). The American Medical Association and other groups have opposed any form of NHI. The Social Security Amendments of 1965 led to the formation of Medicare, a program of health insurance for the aged, and Medicaid, a health insurance program for the indigent, aged, blind, and disabled. Recently, changes in Medicare were made by the Medicare Catastrophic Coverage Act of 1988. Despite the highly-structured medical care system of the United States, 35 million Americans under the age of 65 years remain uninsured. This group includes 15 million employed uninsured, who work for at least part of the year; nine million nonworking uninsured, including the homeless; and one million medically uninsurable, such as individuals with acquired immunodeficiency syndrome (AIDS). The possible future directions for national health insurance in the United States are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)